Cao Qinqin, Zhang Jun, Xu Gelin
Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
Interv Neurol. 2015 Jan;3(1):13-21. doi: 10.1159/000366231.
Atherosclerotic carotid lesion is a major cause of stroke which accounts for up to 20% of ischemic stroke. Aggressive treatment of carotid stenosis may prevent stroke. Currently, carotid endarterectomy (CEA) and carotid artery stenting (CAS) are the first-line treatments for severe carotid stenosis. CEA is superior to medical therapy in preventing stroke and cardiovascular death. CAS has emerged as an alternative to CEA in recent years due to its less invasive nature. However, both CEA and CAS may be associated with adverse hemodynamic changes as well as a variation of carotid baroreflex sensitivity. There is no consensus on which of these two methods is more advantageous concerning the procedure-related hemodynamic changes. This article reviews the hemodynamic changes and baroreflex sensitivity after CEA and CAS.
动脉粥样硬化性颈动脉病变是中风的主要原因，占缺血性中风的比例高达20%。积极治疗颈动脉狭窄可能预防中风。目前，颈动脉内膜切除术（CEA）和颈动脉支架置入术（CAS）是重度颈动脉狭窄的一线治疗方法。CEA在预防中风和心血管死亡方面优于药物治疗。近年来，由于CAS侵入性较小，已成为CEA的替代方法。然而，CEA和CAS都可能与不良血流动力学变化以及颈动脉压力反射敏感性改变有关。关于这两种方法在与手术相关的血流动力学变化方面哪种更具优势，目前尚无共识。本文综述了CEA和CAS术后的血流动力学变化及压力反射敏感性。
